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The waiting game

Locum GPs forced to claim benefits as work dries up

Exclusive Locum GPs have been forced to claim state benefits after struggles to find work during the pandemic, Pulse has learned.

Locum GPs say that the reduction in patient demand for GP services during the pandemic has meant practices are less willing to use them.

At the same time, locum GPs told Pulse they are facing bureaucratic hurdles to join NHS 111's Covid Clinical Assessment Service, and retired GPs have offered to work for free for GP practices.

This has particularly hit locum GPs who have been ‘shielding’, and the lack of sickness benefits means that the self-employed GPs are having to decide whether to take the risk of exposure or not working.

Sessional GP leaders said they have been ‘cast aside’ since the pandemic started.

Dr Saumya Jha, a locum GP based in North London, told Pulse that she had to claim benefits having been unable to find lower-risk shifts such as remote triage and patient letters. She hasn’t worked since March, when she contracted Covid-19, she added.

Dr Jha told Pulse: ‘Things are just cancelled last minute and the shifts that are available are very hard to come by and are high-risk shifts with very limited PPE.

‘So people are really struggling to find employment because either you take the risk of high viral load exposure or you don’t work at all.’

One locum colleague has gone from earning £130,000 working 10 sessions last year to nothing over the last two and a half months because he is ‘scared’ to work in the high-risk shifts available, she added.

Another GP told the National Association of Sessional GPs (NASGP) that they too have looked at claiming for state benefits after six weeks earning no money as a locum.

The anonymous GP said: ‘It has been hard as locums cancelled at short notice and it has been six weeks trying to get on the onboarding for CCAS to earn minimum wage.

‘I have looked at claiming state benefit honestly but [am] hopeful the CCAS onboarding will come through and I might not need to.’

‘Honestly speaking, [I‘m] living from hand to mouth - very depressing as I feel underutilised and very insignificant.’’

NASGP chair Dr Richard Fieldhouse told Pulse that locums are being ‘cast aside’, particularly over the CCAS service that initially targeted retired GPs.

He said: ‘People feel really let down because retired GPs and medical students have been prioritised ahead of the existing locum workforce.

‘Locums are saying they’ve come across retired GPs who aren’t going to even ask for payment, they just want to do it to help out. [But] there are people desperate to pay the mortgage here.’

Meanwhile, locums - many of whom are more recently qualified and have not yet ‘built up financial resilience’ - are left with ‘absolutely no income protection scheme or sick leave scheme’, he added.

Nottinghamshire LMC wrote to locums last month to offer its support and reassure sessional GPs that they are ‘not forgotten’.

LMC GP retention lead Dr Sonali Kinra and chief executive Michael Wright wrote: ‘We acknowledge that there are limited locum opportunities currently.

‘The reasons are multiple - cancellation of annual leave amongst doctors and fear among patients thereby not accessing care, to highlight a few.’

GPs were encouraged to join an LMC GP ‘roving scheme’ that matches staff to areas of need ‘with appropriate PPE and IT equipment’ and to consider a fixed term contract modelled by the BMA.

It comes as Pulse revealed last week that locums were facing six-week long waits to access work at NHS 111’s Covid clinical assessment service (CCAS) - while NHS England said that it ‘still needs clinicians’ to staff the service.

Earlier this month, the BMA told Pulse it had provided an ‘off-the-shelf template contract’ for local areas to offer to locums while they still lack full death-in-service benefits.

Readers' comments (144)

  • 1.38 is correct. Your fees should reflect the lack of benefits available to permanent roles.

    I am sympathetic to locums, but that sympathy has been tempered by the bile partners seem to get from out of work locums for cancelling shifts??

    We are not a charity? We are in a business relationship where locums offer work when it is needed?

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  • I find it incredible that some locum GPs prefer to seek state benefits rather than taking up a Partnership or salaried posts. Really? Are substantive posts THAT bad?

    And how long do you exactly plan to continue your LOCUM OR BUST path? Get real people. Remember you have a choice. But should you continue to choose the harder path then dont go looking for sympathy from people whose ranks you so despise to join.

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  • Whoaml at 12:50pm only locum on here that makes sense! Choose to be self employed with no fixed contracted work and take the risk. Surely some forward planning for a drought of work should be considered for those taking this path? Or in fact anyone relying on ad hoc work. The average locum rate is high enough that some £ put by for a rainy day is common sense, and some kind of insurance policy to protect income.
    I have little sympathy I’m afraid.
    I’m on my own and not part of a PCN and should I not be able to work for whatever reason and fulfil my contract delivery I run huge risks.
    Never had any interest in my ads for a salaried/ partner. Any takers now?

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  • Basic misunderstanding of markets by most here. Locums are simply the first to feel a lower demand ok General Practice. However if market demand remains low for General Practice then it is only a matter of time before salaried GPs and partners take a pay cut.

    The current state of the market should concern all GPs.

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  • If I return to locuming, I will certainly put my rates up to make sure I am able to put some money aside for times like these.

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  • 1.43 is absolutely right no bile should be directed to anyone practices are businesses, a point I had to make to fellow partners sometimes in my previous role
    1.46 I had to leave partnership for family relocate reasons I would love to return to partnership but I’m not seeing all these opportunities mentioned upthread I don’t disbelieve those who say they are offering them but if not being filled then the offer is not what the “market” wants
    Again been in the other side of this in what trainees always used to say was a desirable practice made what we thought was the best pitch we could afford and had no takers
    Maybe the whole model of primary care is dead business wise BMA could help I suppose but busy supporting the teachers right now who I think have their own union

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  • Guys stop in-fighting....... general practice has gone to s**t for all of us...... I left the UK as I considered it that bad, partnership, salaried, locum... it didnt matter.... it was ALL underpaid for the years of training and responsibilities..... you are ALL underpaid back in the UK. Wage stagnation has hit badly. Stop fight amongst each other and fight as one...... as a speciality we got very badly left behind and dont have the big compensation of private practice. Let me put it in perspective.... Ive never earned under £1000/day here in Australia.....never...... and my indemnity is a lot lower too..... £1500 for the year...even in Australia the specialists make a hell of a lot more..... General Practice is Dead...... until you ALL stand together and send in mass resignations all this talk all achieve nothing.... dont blame each other, look at the common enemy......... and FFS stop squabbling, you've ALL been done over......

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  • 6 sessions at £10K salaried
    20% superannuation
    13.8% employers NI contribution
    £500 indemnity
    A salaried 3days a week costs over £80K a year to the practice.
    6weeks A/L, 1 week study , 6 bank holidays is prorata if 8 sessions =FTE
    That's 9 weeks of the year when your salaried is not doing practice work.
    £80K over 43 weeks is £310 per session.
    If your salaried goes off sick or away for anything else that sessional rate goes up significantly.
    If you've got a decent locum who works a good session for you they are NOT expensive!!!

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  • I don’t think anyone is actually doing both ( ie partnership & Locum) hence the unbalanced or completely one sided views. Up until few years ago I was 100% Locum and phased myself through salaried into partnership and still locum here and there, I know colleagues who are 6 sessions partners and still do Locum sessions such as OOH. I’m presently at a more 80/20 split before COVID.

    1) Firstly as a Locum and utilising locums, is certainly a lifeline for practices. I have therefore continued to honour the work we offer our Locums as I know when times are tough ( both ways) such actions are remembered and reciprocated and not a feeling of abuse on both sides ie Locum ‘ raising rates’ or partners cancelling shifts with 24 hr notice .

    2) As a locum or partner if you don’t understand the concept of market forces, demand ( COVID aside) and how to minimise the financial risk of your chosen path then please take on a salaried role as the aforementioned is not for you.

    3) We advertised for a salaried GP/ ANP reply last year. We got zero replies, so we contracted a Locum and the model is financially viable for both parties temporarily at present.

    However rather than blame the system ,we seriously start looking at how we work and I start reflecting back to why as a salaried I began to feel bitter about my day or actually what my concerns were as partner or the “ back in our day we had it tough “ from the senior partner ( refer to four Yorkshireman monty python sketch) way of doing thing. This effort is slowly coming to fruition with said Locums asking if they could have more permanent roles !

    4 ) Finally , I’m sure there is one thing which we can all agree a price on for £0..... Respect.

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  • And stop letting the specialists dictate what you can and cannot do.... the RCGP and its serial weak 'wont rock the boat' leadership has been part of the problem....thats let the government and other specialities walk all over us... seriously look at HSL and her social prescribing BS, too many cosy-ups in London.......if GPs stood together you'd have an organisation worth fighting for.... but most dont see it and are too busy rolling over and playing dead that those of us who are willing to fight realise we can't get the numbers up to make the difference..... thats why I left...... and I still dont regret that decision.... I am sad however to see the state of modern UK general practice.... it is a job unfulfilled and a lot of very talented people under-utilised..... when you start the revolution give me a call.......I'll sign up again...but not until theres fighting spirit..... Prof Martin if you could be a bit more Doc Martin, wear a pair, and give Hancock a good kick in the you know where...... then you might get the faith going again.....

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